Provider Demographics
NPI:1376822387
Name:WILLIAMS, CRYSTAL LYNETTE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:LYNETTE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 PELHAM PARKWAY SOUTH. DEPARTMENT OF DENTISTRY
Mailing Address - Street 2:JACOBI MEDICAL CENTER
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461
Mailing Address - Country:US
Mailing Address - Phone:718-918-3419
Mailing Address - Fax:
Practice Address - Street 1:1400 PELHAM PARKWAY SOUTH. DEPARTMENT OF DENTISTRY
Practice Address - Street 2:JACOBI MEDICAL CENTER
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-918-3419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program